Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma

Detalhes bibliográficos
Autor(a) principal: Zhang, XF
Data de Publicação: 2018
Outros Autores: Chakedis, J, Bagante, F, Chen, Q, Beal, EW, Lv, Y, Weiss, M, Popescu, I, Pinto Marques, H, Aldrighetti, L, Maithel, SK, Pulitano, C, Bauer, TW, Shen, F, Poultsides, GA, Soubrane, O, Martel, G, Groot Koerkamp, B, Guglielmi, A, Itaru, E, Pawlik, TM
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.17/4418
Resumo: Background: The role of routine lymph node dissection (LND) in the surgical treatment of intrahepatic cholangiocarcinoma (ICC) remains controversial. The objective of this study was to investigate the trends of LND use in the surgical treatment of ICC. Methods: Patients undergoing curative intent resection for ICC in 2000-2015 were identified from an international multi-institutional database. Use of lymphadenectomy was evaluated over time and by geographical region (West versus East); LND use and final nodal status were analysed relative to AJCC T categories. Results: Among the 1084 patients identified, half (535, 49·4 per cent) underwent concomitant hepatic resection and LND. Between 2000 and 2015, the proportion of patients undergoing LND for ICC nearly doubled: 44·4 per cent in 2000 versus 81·5 per cent in 2015 (P < 0·001). Use of LND increased over time among both Eastern and Western centres. The odds of LND was associated with the time period of surgery and the extent of the tumour/T status (referent T1a: OR 2·43 for T2, P = 0·001; OR 2·13 for T3, P = 0·016). Among the 535 patients who had LND, lymph node metastasis (LNM) was noted in 209 (39·1 per cent). Specifically, the incidence of LNM was 24 per cent in T1a disease, 22 per cent in T1b, 42·9 per cent in T2, 48 per cent in T3 and 66 per cent in T4 (P < 0·001). AJCC T3 and T4 categories, harvesting of six or more lymph nodes, and presence of satellite lesions were independently associated with LNM. Conclusion: The rate of LNM was high across all T categories, with one in five patients with T1 disease having nodal metastasis. The trend in increased use of LND suggests a growing adoption of AJCC recommendations in the treatment of ICC.
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spelling Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic CholangiocarcinomaHCC CIRAgedFemaleMaleHumansMiddle AgedBile Duct Neoplasms / classificationBile Duct Neoplasms / pathologyBile Duct Neoplasms / surgery*Cholangiocarcinoma / classificationCholangiocarcinoma / pathologyCholangiocarcinoma / surgery*Databases, FactualHepatectomyLymph Node Excision / statistics & numerical data*Lymphatic MetastasisNeoplasm StagingBackground: The role of routine lymph node dissection (LND) in the surgical treatment of intrahepatic cholangiocarcinoma (ICC) remains controversial. The objective of this study was to investigate the trends of LND use in the surgical treatment of ICC. Methods: Patients undergoing curative intent resection for ICC in 2000-2015 were identified from an international multi-institutional database. Use of lymphadenectomy was evaluated over time and by geographical region (West versus East); LND use and final nodal status were analysed relative to AJCC T categories. Results: Among the 1084 patients identified, half (535, 49·4 per cent) underwent concomitant hepatic resection and LND. Between 2000 and 2015, the proportion of patients undergoing LND for ICC nearly doubled: 44·4 per cent in 2000 versus 81·5 per cent in 2015 (P < 0·001). Use of LND increased over time among both Eastern and Western centres. The odds of LND was associated with the time period of surgery and the extent of the tumour/T status (referent T1a: OR 2·43 for T2, P = 0·001; OR 2·13 for T3, P = 0·016). Among the 535 patients who had LND, lymph node metastasis (LNM) was noted in 209 (39·1 per cent). Specifically, the incidence of LNM was 24 per cent in T1a disease, 22 per cent in T1b, 42·9 per cent in T2, 48 per cent in T3 and 66 per cent in T4 (P < 0·001). AJCC T3 and T4 categories, harvesting of six or more lymph nodes, and presence of satellite lesions were independently associated with LNM. Conclusion: The rate of LNM was high across all T categories, with one in five patients with T1 disease having nodal metastasis. The trend in increased use of LND suggests a growing adoption of AJCC recommendations in the treatment of ICC.WileyRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEZhang, XFChakedis, JBagante, FChen, QBeal, EWLv, YWeiss, MPopescu, IPinto Marques, HAldrighetti, LMaithel, SKPulitano, CBauer, TWShen, FPoultsides, GASoubrane, OMartel, GGroot Koerkamp, BGuglielmi, AItaru, EPawlik, TM2023-02-20T16:25:38Z20182018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4418engBr J Surg . 2018 Jun;105(7):857-866.10.1002/bjs.10827info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:46:23Zoai:repositorio.chlc.min-saude.pt:10400.17/4418Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:21:46.270328Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
title Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
spellingShingle Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
Zhang, XF
HCC CIR
Aged
Female
Male
Humans
Middle Aged
Bile Duct Neoplasms / classification
Bile Duct Neoplasms / pathology
Bile Duct Neoplasms / surgery*
Cholangiocarcinoma / classification
Cholangiocarcinoma / pathology
Cholangiocarcinoma / surgery*
Databases, Factual
Hepatectomy
Lymph Node Excision / statistics & numerical data*
Lymphatic Metastasis
Neoplasm Staging
title_short Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
title_full Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
title_fullStr Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
title_full_unstemmed Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
title_sort Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma
author Zhang, XF
author_facet Zhang, XF
Chakedis, J
Bagante, F
Chen, Q
Beal, EW
Lv, Y
Weiss, M
Popescu, I
Pinto Marques, H
Aldrighetti, L
Maithel, SK
Pulitano, C
Bauer, TW
Shen, F
Poultsides, GA
Soubrane, O
Martel, G
Groot Koerkamp, B
Guglielmi, A
Itaru, E
Pawlik, TM
author_role author
author2 Chakedis, J
Bagante, F
Chen, Q
Beal, EW
Lv, Y
Weiss, M
Popescu, I
Pinto Marques, H
Aldrighetti, L
Maithel, SK
Pulitano, C
Bauer, TW
Shen, F
Poultsides, GA
Soubrane, O
Martel, G
Groot Koerkamp, B
Guglielmi, A
Itaru, E
Pawlik, TM
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE
dc.contributor.author.fl_str_mv Zhang, XF
Chakedis, J
Bagante, F
Chen, Q
Beal, EW
Lv, Y
Weiss, M
Popescu, I
Pinto Marques, H
Aldrighetti, L
Maithel, SK
Pulitano, C
Bauer, TW
Shen, F
Poultsides, GA
Soubrane, O
Martel, G
Groot Koerkamp, B
Guglielmi, A
Itaru, E
Pawlik, TM
dc.subject.por.fl_str_mv HCC CIR
Aged
Female
Male
Humans
Middle Aged
Bile Duct Neoplasms / classification
Bile Duct Neoplasms / pathology
Bile Duct Neoplasms / surgery*
Cholangiocarcinoma / classification
Cholangiocarcinoma / pathology
Cholangiocarcinoma / surgery*
Databases, Factual
Hepatectomy
Lymph Node Excision / statistics & numerical data*
Lymphatic Metastasis
Neoplasm Staging
topic HCC CIR
Aged
Female
Male
Humans
Middle Aged
Bile Duct Neoplasms / classification
Bile Duct Neoplasms / pathology
Bile Duct Neoplasms / surgery*
Cholangiocarcinoma / classification
Cholangiocarcinoma / pathology
Cholangiocarcinoma / surgery*
Databases, Factual
Hepatectomy
Lymph Node Excision / statistics & numerical data*
Lymphatic Metastasis
Neoplasm Staging
description Background: The role of routine lymph node dissection (LND) in the surgical treatment of intrahepatic cholangiocarcinoma (ICC) remains controversial. The objective of this study was to investigate the trends of LND use in the surgical treatment of ICC. Methods: Patients undergoing curative intent resection for ICC in 2000-2015 were identified from an international multi-institutional database. Use of lymphadenectomy was evaluated over time and by geographical region (West versus East); LND use and final nodal status were analysed relative to AJCC T categories. Results: Among the 1084 patients identified, half (535, 49·4 per cent) underwent concomitant hepatic resection and LND. Between 2000 and 2015, the proportion of patients undergoing LND for ICC nearly doubled: 44·4 per cent in 2000 versus 81·5 per cent in 2015 (P < 0·001). Use of LND increased over time among both Eastern and Western centres. The odds of LND was associated with the time period of surgery and the extent of the tumour/T status (referent T1a: OR 2·43 for T2, P = 0·001; OR 2·13 for T3, P = 0·016). Among the 535 patients who had LND, lymph node metastasis (LNM) was noted in 209 (39·1 per cent). Specifically, the incidence of LNM was 24 per cent in T1a disease, 22 per cent in T1b, 42·9 per cent in T2, 48 per cent in T3 and 66 per cent in T4 (P < 0·001). AJCC T3 and T4 categories, harvesting of six or more lymph nodes, and presence of satellite lesions were independently associated with LNM. Conclusion: The rate of LNM was high across all T categories, with one in five patients with T1 disease having nodal metastasis. The trend in increased use of LND suggests a growing adoption of AJCC recommendations in the treatment of ICC.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-01-01T00:00:00Z
2023-02-20T16:25:38Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.17/4418
url http://hdl.handle.net/10400.17/4418
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Br J Surg . 2018 Jun;105(7):857-866.
10.1002/bjs.10827
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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